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Emerging Concepts and Controversies in Renal Pathology: C4d-Negative and Arterial Lesions as Manifestations of Antibody-Mediated Transplant Rejection

机译:肾病理学中的新兴概念和争议:C4d阴性和动脉病变是抗体介导的移植排斥反应的表现

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The consensus classification of antibody-mediated rejection (AMR) of renal allografts developed at the Sixth Banff Conference on Allograft Pathology, in 2001, identified three findings necessary for the diagnosis of active AMR: histologic evidence, antibodies against the graft, and capillary C4d deposition. Morphologic and molecular studies have noted evidence of microvascular injury, which, in the presence of donor-specific antibodies (DSAs) but the absence of C4d deposition, is associated with development of transplant glomerulopathy and graft loss. Recent studies suggest that intimal arteritis may in some cases be a manifestation of DSA-induced graft injury. These newly recognized lesions of AMR have now been incorporated into a revised Banff diagnostic schema.
机译:在2001年第六届班夫同种异体移植病理学会议上开发的肾脏同种异体移植物的抗体介导排斥(AMR)共识分类确定了诊断活动性AMR所必需的三个发现:组织学证据,针对移植物的抗体和毛细血管C4d沉积。形态学和分子研究已注意到微血管损伤的证据,在存在供体特异性抗体(DSA)但不存在C4d沉积的情况下,微血管损伤与移植肾小球病变和移植物丢失有关。最近的研究表明,在某些情况下,内膜动脉炎可能是DSA诱导的移植物损伤的一种表现。这些新发现的AMR病变现已纳入修订的Banff诊断方案中。

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